PAUL D. PATE Secretary of State State of Iowa TO THE SECRETARY OF STATE OF THE STATE OF IOWA: APPLICATION FOR RESERVATION OF NAME The undersigned applies to reserve exclusive use of a business organization name, pursuant to the: (check one) Iowa Business Corporation Act (profit corporations) Revised Iowa Nonprofit Corporation Act (nonprofit corporations) Iowa Revised Uniform Limited Liability Company Act Iowa Uniform Limited Partnership Act - The new applicant is: (check one) A person intending to organize a limited partnership under this chapter and to adopt the name. A limited partnership or a foreign limited partnership authorized to transact business in this state intending to adopt the name. A foreign limited partnership intending to obtain a certificate of authority to transact business in this state and adopt the name. A person intending to organize a foreign limited partnership and intending to have it obtain a certificate of authority to transact business in this state and adopt the name. A foreign limited partnership formed under the name. A foreign limited partnership formed under a name that does not comply with section 488.108, subsection 2 or 3. Iowa Cooperative Associations Act (Iowa Code Ch. 501A) 1. The name to be reserved is ________________________________________________________________ 2. The name and address of the applicant is Name ________________________________________________________________________________ Address _______________________________________________________________________________ City, State, Zip _________________________________________________________________________ Signature _________________________________________________________________________________ Type or print name & title ____________________________________________________________________ Date ____________________________ NOTES: 1. The filing fee is $10.00. Make checks payable to SECRETARY OF STATE. 2. The information you provide will be open to public inspection under Iowa Code chapter 22.11. SECRETARY OF STATE Business Services Division Lucas Building, 1st Floor Des Moines, Iowa 50319 635_0051 rev 1/15 Phone: (515) 281-5204 FAX: (515) 242-5953 Website: sos.iowa.gov American LegalNet, Inc. www.FormsWorkFlow.com